Caring for our future: Shared ambitions for care and support

1. Caring for our future: Shared ambitions for care and support Adult social care engagement exercise Emerging thinking of the Quality and Workforce Group Imelda Redmond November 2011

2. What is ‘Caring for our future’? • The Government launched Caring for our future: Shared ambitions for care and support was launched on Thursday 15th September and runs until early December. • It is a discussion with people who use care and support services, carers, local councils, care providers, and the voluntary sector about the priorities for improving care and support. • Caring for our future is an opportunity to bring together the recommendations from the Law Commission and the Commission on the Funding of Care and Support with the Government’s Vision for Adult Social Care, and to discuss with stakeholders what the priorities for reform should be.

3. How will the engagement work? • The engagement is looking at six key areas: • Quality and Workforce • Personalisation • Shaping local care services • Prevention • Integration • The role of the financial services • The Government asked a leader from the care and support community to help the Government to lead the discussions for each of the six areas, supported by a small reference group. Our discussions over the autumn will help us shape these priorities. • It also wants to hear people’s views on the recommendations made by the Commission on Funding of Care and Support and how we should assess these proposals, including in relation to other potential priorities for improvement.

4. The Quality and Workforce Reference Group • Our reference group has been considering how we could improve the quality of care and how could we support the care workforce to do this. Reference group co-leads • Imelda Redmond (Carers UK and Marie Curie Cancer Care) • Glen Mason (DH, Workforce) • Luisa Stewart (DH, Quality) Reference Group members • Sharon Allen - Skills for Care • Andrew Dillon - NICE • Julienne Meyer - My Home Life • Mark Goldring - MENCAP • Martin Green - ECCA • Julie Jones - SCIE • Cynthia Bower - CQC

5. Emerging priorities for action (1) • Social care needs to be placed in the broader context of opportunities for economic activity. The spend on social care is billions, yet the sector struggles at times to recruit and retain staff. Unpaid care also makes a large contribution and support for carers to remain economically active is important, also for their own wellbeing. LAs should have a duty to ensure sufficiency of supply for their population (whether LA funded or self-funders). • Consumer information is likely to grow in future as a key driver of quality, encouraging and incentivising care managers and staff to strive to deliver higher quality services. A priority for action is to ensure there is a portal for key information for consumers about the quality of care at provider level (care homes; domiciliary care providers and potentially Personal Assistants). • To enable local authorities to move to commissioning for quality and value for money, we should build on the emerging work from Think Local Act Personal (TLAP), including work in the sector to identify a range of quality metrics and markers at provider level that could be used by commissioners as quality measures in contracting.

6. Emerging priorities for action (2) • Commissioning for quality also requires sufficient funding in the system. The combination of the current funding squeeze and inflation means providers are having to do more for less, which is jeopardising quality. It also jeopardises provision of services (as providers leave the market). • Local authorities should have a duty to ensure sufficiency of supply in their area. • We need to further develop the social care quality framework, building on the Social Care Outcomes Framework and existing quality architecture in the system eg. Local Accounts and developing the NICE quality standards. This needs to set out a clear quality governance framework with the roles, responsibilities and incentives of the respective players eg. providers, councils, regulator, local HealthWatch . We should consider an interim forum (led by the sector) to help define quality and disseminate best practice in a format that is appropriate.

7. Emerging priorities for action (3) • The future of social care will increasingly require a diffuse model of leadership that develops leaders in all settings and at all levels in the sector and is also able to support working across boundaries with health, housing and other areas. We propose: • A senior cross sector forum that would oversee improvement made up of members from the National Skills Academy, NHS Leadership Academy and other high quality leaders from the public, private and voluntary sector. • A National Leadership Fund, overseen by this forum, that funds a variety of different leadership development activities from mentoring for first line managers, funding of a graduate entry programme and elearning opportunities through to development for our most senior leaders. • An approach to leadership development that supports integration, transformation and quality in the sector as the organising principles of adult social care. • Recruitment needs to bring in younger people, those new to retirement and those being displaced from other sectors, by focusing on improving the image of social care, quickly, skilling staff up with a focus on the quality of the relationship between the person using the service and the member of staff and creating clear and varied ways of progressing a career in social care. We propose: • Expanding the existing apprenticeships scheme, with full funding available to 18-25 year old and 60+ age groups • Removing financial and bureaucratic barriers to people becoming volunteers or volunteers becoming members of the paid workforce • Incentivising employers to employ young people by meeting training costs in the first year of employment or meeting the NI costs • Considering a national recruitment drive, creating a brand for social care jobs that is positive and attractive.

8. Commission for funding care and support recommendations: Key findings The group has heard strong support for the Dilnot Commission’s recommendations – people think Government must act now and not delay reform any longer. The strategic approach taken by the Commission supports empowerment of consumers and supports the personalisation/choice agenda. Recommendations of direct relevance to the Quality and workforce agenda are: • Information and advice strategy • Improved assessment and portability of assessment • Improved integration between health and social care

9. Questions for other speakers: • How do these findings resonate with your key messages? • What messages would you wish to reinforce? • What messages are missing?

10. Questions for the audience: • What does great care look like? • How do we achieve this? • What are the levers? • Who does what? e.g. National Government / Local Government / Independent sector / arms length bodies

11. Your feedback: • On-line (http://caringforourfuture.dh.gov.uk/category/priorities/), • Feedback form (caringforourfuture@dh.gsi.gov.uk) or by post to: Caring for our future, Area 117, Wellington House, 133-155 Waterloo Road, London, SE1 8UG • Please note that the deadline for written comments is 2 December 2011.